Are Outcomes of Extremely Preterm Infants Improving? Impact of Bayley Assessment on Outcomes

详细信息    查看全文

• 作者：Betty R. Vohr ; MD¹ ; ^{bvohr@wihri.org} ; Bonnie E. Stephens ; MD¹ ; Rosemary D. Higgins ; MD² ; Carla M. Bann ; PhD³ ; Susan R. Hintz ; MD ; MS Epi⁴ ; Abhik Das ; PhD⁵ ; Jamie E. Newman ; PhD ; MPH³ ; Myriam Peralta-Carcelen ; MD ; MPH⁶ ; Kimberly Yolton ; PhD⁷ ; Anna M. Dusick ; MD ; FAAP⁸ ; Patricia W. Evans ; MD⁹ ; Ricki F. Goldstein ; MD¹⁰ ; Richard A. Ehrenkranz ; MD¹¹ ; Athina Pappas ; MD¹² ; Ira Adams-Chapman ; MD¹³ ; Deanne E. Wilson-Costello ; MD¹⁴ ; Charles R. Bauer ; MD¹⁵ ; Anna Bodnar ; MD¹⁶ ; Roy J. Heyne ; MD¹⁷ ; Yvonne E. Vaucher ; MD ; MPH¹⁸ ; Robert G. Dillard ; MD¹⁹ ; Michael J. Acarregui ; MD²⁰ ; Elisabeth C. McGowan ; MD²¹ ; Gary J. Myers ; MD²² ; Janell Fuller ; MD²³ ; Eunice Kennedy Shriver National Institute of Child Health ; Human Development Neonatal Research Network &lowast
• 关键词：Bayley II ; Bayley Scales of Infant Development ; Second Edition ; Bayley III ; Bayley Scales of Infant and Toddler Development ; Third Edition ; BPD ; Bronchopulmonary dysplasia ; CA ; Corrected age ; Cog ; Cognitive composite ; CP ; Cerebral palsy ; ELBW ; Extremely l
• 刊名：The Journal of Pediatrics
• 出版年：2012
• 出版时间：August, 2012
• 年：2012
• 卷：161
• 期：2
• 页码：222-228.e3
• 全文大小：164 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Objectives

To compare 18- to 22-month cognitive scores and neurodevelopmental impairment (NDI) in 2 time periods using the National Institute of Child Health and Human Development's Neonatal Research Network assessment of extremely low birth weight infants with the Bayley Scales of Infant Development, Second Edition (Bayley II) in 2006-2007 (period 1) and using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), with separate cognitive and language scores, in 2008-2011 (period 2).

Study design

Scores were compared with bivariate analysis, and regression analyses were run to identify differences in NDI rates.

Results

Mean Bayley III cognitive scores were 11 points higher than mean Bayley II cognitive scores. The NDI rate was reduced by 70 % (from 43 % in period 1 to 13 % in period 2; P < .0001). Multivariate analyses revealed that Bayley III contributed to a decreased risk of NDI by 5 definitions: cognitive score <70 and <85, cognitive or language score <70; cognitive or motor score <70, and cognitive, language, or motor score <70 (P < .001).

Conclusion

Whether the Bayley III is overestimating cognitive performance or whether it is a more valid assessment of emerging cognitive skills than the Bayley II is uncertain. Because the Bayley III identifies significantly fewer children with disability, it is recommended that all extremely low birth weight infants be offered early intervention services at the time of discharge from the neonatal intensive care unit, and that Bayley scores be interpreted with caution.